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Relation between Vascular Endothelial Markers and Right Ventricular Function in the Children with Asthma


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 Objectives: The aim of the study was to evaluate the possible relationship of clinical severity during Asthmatic exacerbation with the Ventricular Functions and the levels of vascular endothelial-related biomarkers Endothelin-1 (ET-1) and Platelet-Derived Growth Factor-BB (PDGF-BB) in the condensed breathing air in the children with Asthma. Methods: The study included a total of 80 children with acute Asthmatic episode; of these, 28 had a mild, 26 had a moderate, and 26 had a severe attack. Samples of condensed breathing air were obtained for being analyzed for ET-1 and PDGF-BB levels during the study. All patients were evaluated by echocardiography at the beginning of the study and two weeks after the treatment of Asthmatic episode. Results: Before treatment, mPAP in moderate and severe Asthma groups was significantly higher than in mild Asthma group (21. 6  7. 3, 30. 1  9. 8 and 32. 7  7. 8; P < 0. 01, P < 0. 001, respectively). After treatment, no significant difference was detected between the Asthma groups (P > 0. 05). Am and Em waves, and IVRT, IVCT, ET and RV MPI during the Asthmatic attack and after treatment did not change significantly between the groups; pre-and post-treatment values of these parameters also did not show significant differences. In exhaled air samples of the group with severe Asthma exacerbation ET-1 and PDGF-BB were higher than those in the moderate and mild group (0. 80  0. 42, 0. 58  0. 30, 0. 50  0. 15; P = 0. 002 and 281. 7  253. 2, 167. 3  148. 1, 135. 9  74. 9; P = 0. 008 respectively). Conclusions: Ourstudy resultsshowedthatmPAPin direct proportion with the increasedinflammatory cytokineswassignificantly higher in Asthma attacks and levels of ET-1 and PDGF-BB were significantly increased with severity of Asthma, indicating a vascular response.


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